The ophthalmoscope : its varieties and its use / translated from the German of Adolf Zander by Robert Brudenell Carter ; with notes and additions by the translator.

Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: The ophthalmoscope : its varieties and its use / translated from the German of Adolf Zander by Robert Brudenell Carter ; with notes and additions by the translator. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    26/270 (page 4)
    nucleus, long previously yellow, but in the anterior and posterior layers immediately surrounding it. We now know also, that all the opacities that are connected with diseases of the choroid or of the vitreous body, have their point of origin at the posterior pole of the lens; and, formerly, the different signs which were relied upon in order to distinguish com- mencing cataract from amblyopia were so uncertain that the surgeon would often subject his patient to months or years of harassing treatment, and would only discover his error when it became evident, even to a layman, that the case was one of grey cataract, and not the commence- ment of amaurosis. With regard to affections of the vitreous body, the ophthalmoscope has revealed the frequent occurrence of effusions of blood into its sub- stance ; and that such effusions may, in the course of a few weeks, become absorbed. It has enabled us to estimate the connection and setiological relations between floating opacities and choroidal disease. It has shown the peculiar seat of cholesterine crystals, the presence of living entozoa, and of foreign bodies that have penetrated the organ; and, in the form of iritis known as aquo-capsulitis, in which the impairment of sight is often disproportionate to the degree of opacity visible either to the naked eye, or with a lens and oblique illumination, the ophthalmoscope has shown that this impairment is caused by the infiltration of the whole vitreous body with floating molecules, and has thus proved the frequent sympathy of the inner membranes with the more evident disease. In the disorders of the inner membranes themselves, of the choroid, retina, and optic nerve—almost a terra incognita before its discovery— the ophthalmoscope has rendered assistance equally great. We are indebted to it for an exact knowledge of inflammation, pigmentary changes, apo- plexy, and posterior staphyloma of the choroid, as well as of hyperemia, inflammation, hsernorrhage, atrophy, fatty degeneration, and separation of the retina. It has reduced to an impossibility Walther's definition of amaurosis, as a state in which the patient sees nothing and the surgeon likewise nothing/' since the bugbears of ophthalmology, that formerly concealed themselves under the names glaucoma, amblyopia, and amau- rosis, have been for the most part traced to definite anatomical conditions. Through its assistance, therefore, in the place of doubt we have certainty; and in the place of inductive reasoning the direct perceptions of sense; which last alone can be accepted as certain truths by the inquiring spirit of natural science. The instrument has been not less valuable as a help to rational therapeutics, than as the basis of rational pathology. So long as the old Hippocratic maxim, qui bene noscit, bene curat, expresses a truth— so long as an exact knowledge of the seat and causes of disease is essential to the application of rational treatment—so long may we